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Charge Type Price  
Hospital Charge Code 901602726
Hospital Revenue Code 272
Min. Negotiated Rate $22.59
Max. Negotiated Rate $101.65
Rate for Payer: Cash Price $50.82
Rate for Payer: Central Health Plan Commercial $90.35
Rate for Payer: EPIC Health Plan Commercial $45.18
Rate for Payer: Galaxy Health WC $96.00
Rate for Payer: Global Benefits Group Commercial $67.76
Rate for Payer: Health Management Network EPO/PPO $101.65
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $75.33
Rate for Payer: LLUH Dept of Risk Management WC $22.59
Rate for Payer: Multiplan Commercial $84.70
Rate for Payer: Networks By Design Commercial $73.41
Rate for Payer: Prime Health Services Commercial $96.00
Hospital Charge Code 901602726
Hospital Revenue Code 272
Min. Negotiated Rate $22.59
Max. Negotiated Rate $101.65
Rate for Payer: Aetna of CA HMO/PPO $68.59
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $96.00
Rate for Payer: AlphaCare Medical Group Medi-Cal $62.12
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $62.12
Rate for Payer: Anthem Blue Cross of CA Exchange $54.69
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $66.72
Rate for Payer: BCBS Transplant Transplant $67.76
Rate for Payer: Blue Shield of California Commercial $71.04
Rate for Payer: Blue Shield of California EPN $55.23
Rate for Payer: Cash Price $50.82
Rate for Payer: Central Health Plan Commercial $90.35
Rate for Payer: Cigna of CA HMO $72.28
Rate for Payer: Cigna of CA PPO $83.58
Rate for Payer: Dignity Health Commercial/Exchange $96.00
Rate for Payer: EPIC Health Plan Commercial $45.18
Rate for Payer: EPIC Health Plan Transplant $45.18
Rate for Payer: Galaxy Health WC $96.00
Rate for Payer: Global Benefits Group Commercial $67.76
Rate for Payer: Health Management Network EPO/PPO $101.65
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $84.70
Rate for Payer: IEHP medi-cal $39.53
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $75.33
Rate for Payer: LLUH Dept of Risk Management WC $22.59
Rate for Payer: Multiplan Commercial $84.70
Rate for Payer: Networks By Design Commercial $73.41
Rate for Payer: Prime Health Services Commercial $96.00
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $67.76
Rate for Payer: Riverside University Health MISP $45.18
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $67.76
Rate for Payer: TriValley Medical Group Commercial/Senior $67.76
Rate for Payer: United Healthcare All Other Commercial $56.47
Rate for Payer: United Healthcare All Other HMO $56.47
Rate for Payer: United Healthcare HMO Rider $56.47
Rate for Payer: United Healthcare Select/Navigate/Core $56.47
Rate for Payer: Vantage Medical Group Medi-Cal $96.00
Rate for Payer: Vantage Medical Group Senior $96.00
Hospital Charge Code 901602725
Hospital Revenue Code 272
Min. Negotiated Rate $22.82
Max. Negotiated Rate $102.67
Rate for Payer: Aetna of CA HMO/PPO $69.28
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $96.97
Rate for Payer: AlphaCare Medical Group Medi-Cal $62.74
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $62.74
Rate for Payer: Anthem Blue Cross of CA Exchange $55.24
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $67.40
Rate for Payer: BCBS Transplant Transplant $68.45
Rate for Payer: Blue Shield of California Commercial $71.76
Rate for Payer: Blue Shield of California EPN $55.79
Rate for Payer: Cash Price $51.34
Rate for Payer: Central Health Plan Commercial $91.26
Rate for Payer: Cigna of CA HMO $73.01
Rate for Payer: Cigna of CA PPO $84.42
Rate for Payer: Dignity Health Commercial/Exchange $96.97
Rate for Payer: EPIC Health Plan Commercial $45.63
Rate for Payer: EPIC Health Plan Transplant $45.63
Rate for Payer: Galaxy Health WC $96.97
Rate for Payer: Global Benefits Group Commercial $68.45
Rate for Payer: Health Management Network EPO/PPO $102.67
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $85.56
Rate for Payer: IEHP medi-cal $39.93
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $76.09
Rate for Payer: LLUH Dept of Risk Management WC $22.82
Rate for Payer: Multiplan Commercial $85.56
Rate for Payer: Networks By Design Commercial $74.15
Rate for Payer: Prime Health Services Commercial $96.97
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $68.45
Rate for Payer: Riverside University Health MISP $45.63
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $68.45
Rate for Payer: TriValley Medical Group Commercial/Senior $68.45
Rate for Payer: United Healthcare All Other Commercial $57.04
Rate for Payer: United Healthcare All Other HMO $57.04
Rate for Payer: United Healthcare HMO Rider $57.04
Rate for Payer: United Healthcare Select/Navigate/Core $57.04
Rate for Payer: Vantage Medical Group Medi-Cal $96.97
Rate for Payer: Vantage Medical Group Senior $96.97
Hospital Charge Code 901602725
Hospital Revenue Code 272
Min. Negotiated Rate $22.82
Max. Negotiated Rate $102.67
Rate for Payer: Cash Price $51.34
Rate for Payer: Central Health Plan Commercial $91.26
Rate for Payer: EPIC Health Plan Commercial $45.63
Rate for Payer: Galaxy Health WC $96.97
Rate for Payer: Global Benefits Group Commercial $68.45
Rate for Payer: Health Management Network EPO/PPO $102.67
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $76.09
Rate for Payer: LLUH Dept of Risk Management WC $22.82
Rate for Payer: Multiplan Commercial $85.56
Rate for Payer: Networks By Design Commercial $74.15
Rate for Payer: Prime Health Services Commercial $96.97
Service Code CPT C1729
Hospital Charge Code 901602839
Hospital Revenue Code 278
Min. Negotiated Rate $116.00
Max. Negotiated Rate $522.00
Rate for Payer: Aetna of CA HMO/PPO $312.06
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $493.00
Rate for Payer: AlphaCare Medical Group Medi-Cal $319.00
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $319.00
Rate for Payer: Anthem Blue Cross of CA Exchange $264.83
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $323.06
Rate for Payer: BCBS Transplant Transplant $348.00
Rate for Payer: Blue Shield of California Commercial $435.00
Rate for Payer: Blue Shield of California EPN $315.52
Rate for Payer: Cash Price $261.00
Rate for Payer: Cash Price $261.00
Rate for Payer: Central Health Plan Commercial $464.00
Rate for Payer: Cigna of CA HMO $406.00
Rate for Payer: Cigna of CA PPO $406.00
Rate for Payer: Dignity Health Commercial/Exchange $493.00
Rate for Payer: EPIC Health Plan Commercial $232.00
Rate for Payer: EPIC Health Plan Transplant $232.00
Rate for Payer: Galaxy Health WC $493.00
Rate for Payer: Global Benefits Group Commercial $348.00
Rate for Payer: Health Management Network EPO/PPO $522.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $435.00
Rate for Payer: IEHP medi-cal $203.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $386.86
Rate for Payer: LLUH Dept of Risk Management WC $116.00
Rate for Payer: Multiplan Commercial $435.00
Rate for Payer: Networks By Design Commercial $290.00
Rate for Payer: Prime Health Services Commercial $493.00
Rate for Payer: Riverside University Health MISP $232.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $348.00
Rate for Payer: TriValley Medical Group Commercial/Senior $348.00
Rate for Payer: United Healthcare All Other Commercial $290.00
Rate for Payer: United Healthcare All Other HMO $290.00
Rate for Payer: United Healthcare HMO Rider $290.00
Rate for Payer: United Healthcare Select/Navigate/Core $290.00
Rate for Payer: Vantage Medical Group Medi-Cal $493.00
Rate for Payer: Vantage Medical Group Senior $493.00
Service Code CPT C1729
Hospital Charge Code 901602839
Hospital Revenue Code 278
Min. Negotiated Rate $116.00
Max. Negotiated Rate $522.00
Rate for Payer: Blue Shield of California EPN $309.72
Rate for Payer: Cash Price $261.00
Rate for Payer: Central Health Plan Commercial $464.00
Rate for Payer: Cigna of CA HMO $406.00
Rate for Payer: Cigna of CA PPO $406.00
Rate for Payer: EPIC Health Plan Commercial $232.00
Rate for Payer: EPIC Health Plan Transplant $232.00
Rate for Payer: Galaxy Health WC $493.00
Rate for Payer: Global Benefits Group Commercial $348.00
Rate for Payer: Health Management Network EPO/PPO $522.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $386.86
Rate for Payer: LLUH Dept of Risk Management WC $116.00
Rate for Payer: Multiplan Commercial $435.00
Rate for Payer: Prime Health Services Commercial $493.00
Hospital Charge Code 901695700
Hospital Revenue Code 272
Min. Negotiated Rate $2.46
Max. Negotiated Rate $11.07
Rate for Payer: Aetna of CA HMO/PPO $7.47
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $10.46
Rate for Payer: AlphaCare Medical Group Medi-Cal $6.76
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $6.76
Rate for Payer: Anthem Blue Cross of CA Exchange $5.96
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $7.27
Rate for Payer: BCBS Transplant Transplant $7.38
Rate for Payer: Blue Shield of California Commercial $7.74
Rate for Payer: Blue Shield of California EPN $6.01
Rate for Payer: Cash Price $5.54
Rate for Payer: Central Health Plan Commercial $9.84
Rate for Payer: Cigna of CA HMO $7.87
Rate for Payer: Cigna of CA PPO $9.10
Rate for Payer: Dignity Health Commercial/Exchange $10.46
Rate for Payer: EPIC Health Plan Commercial $4.92
Rate for Payer: EPIC Health Plan Transplant $4.92
Rate for Payer: Galaxy Health WC $10.46
Rate for Payer: Global Benefits Group Commercial $7.38
Rate for Payer: Health Management Network EPO/PPO $11.07
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $9.22
Rate for Payer: IEHP medi-cal $4.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $8.20
Rate for Payer: LLUH Dept of Risk Management WC $2.46
Rate for Payer: Multiplan Commercial $9.22
Rate for Payer: Networks By Design Commercial $8.00
Rate for Payer: Prime Health Services Commercial $10.46
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $7.38
Rate for Payer: Riverside University Health MISP $4.92
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $7.38
Rate for Payer: TriValley Medical Group Commercial/Senior $7.38
Rate for Payer: United Healthcare All Other Commercial $6.15
Rate for Payer: United Healthcare All Other HMO $6.15
Rate for Payer: United Healthcare HMO Rider $6.15
Rate for Payer: United Healthcare Select/Navigate/Core $6.15
Rate for Payer: Vantage Medical Group Medi-Cal $10.46
Rate for Payer: Vantage Medical Group Senior $10.46
Hospital Charge Code 901695700
Hospital Revenue Code 272
Min. Negotiated Rate $2.46
Max. Negotiated Rate $11.07
Rate for Payer: Cash Price $5.54
Rate for Payer: Central Health Plan Commercial $9.84
Rate for Payer: EPIC Health Plan Commercial $4.92
Rate for Payer: Galaxy Health WC $10.46
Rate for Payer: Global Benefits Group Commercial $7.38
Rate for Payer: Health Management Network EPO/PPO $11.07
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $8.20
Rate for Payer: LLUH Dept of Risk Management WC $2.46
Rate for Payer: Multiplan Commercial $9.22
Rate for Payer: Networks By Design Commercial $8.00
Rate for Payer: Prime Health Services Commercial $10.46
Hospital Charge Code 901698219
Hospital Revenue Code 271
Min. Negotiated Rate $47.60
Max. Negotiated Rate $214.20
Rate for Payer: Aetna of CA HMO/PPO $144.54
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $202.30
Rate for Payer: AlphaCare Medical Group Medi-Cal $130.90
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $130.90
Rate for Payer: Anthem Blue Cross of CA Exchange $115.24
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $140.61
Rate for Payer: BCBS Transplant Transplant $142.80
Rate for Payer: Blue Shield of California Commercial $149.70
Rate for Payer: Blue Shield of California EPN $116.38
Rate for Payer: Cash Price $107.10
Rate for Payer: Central Health Plan Commercial $190.40
Rate for Payer: Cigna of CA HMO $152.32
Rate for Payer: Cigna of CA PPO $176.12
Rate for Payer: Dignity Health Commercial/Exchange $202.30
Rate for Payer: EPIC Health Plan Commercial $95.20
Rate for Payer: EPIC Health Plan Transplant $95.20
Rate for Payer: Galaxy Health WC $202.30
Rate for Payer: Global Benefits Group Commercial $142.80
Rate for Payer: Health Management Network EPO/PPO $214.20
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $178.50
Rate for Payer: IEHP medi-cal $83.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $158.75
Rate for Payer: LLUH Dept of Risk Management WC $47.60
Rate for Payer: Multiplan Commercial $178.50
Rate for Payer: Networks By Design Commercial $154.70
Rate for Payer: Prime Health Services Commercial $202.30
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $142.80
Rate for Payer: Riverside University Health MISP $95.20
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $142.80
Rate for Payer: TriValley Medical Group Commercial/Senior $142.80
Rate for Payer: United Healthcare All Other Commercial $119.00
Rate for Payer: United Healthcare All Other HMO $119.00
Rate for Payer: United Healthcare HMO Rider $119.00
Rate for Payer: United Healthcare Select/Navigate/Core $119.00
Rate for Payer: Vantage Medical Group Medi-Cal $202.30
Rate for Payer: Vantage Medical Group Senior $202.30
Hospital Charge Code 901698219
Hospital Revenue Code 271
Min. Negotiated Rate $47.60
Max. Negotiated Rate $214.20
Rate for Payer: Cash Price $107.10
Rate for Payer: Central Health Plan Commercial $190.40
Rate for Payer: EPIC Health Plan Commercial $95.20
Rate for Payer: Galaxy Health WC $202.30
Rate for Payer: Global Benefits Group Commercial $142.80
Rate for Payer: Health Management Network EPO/PPO $214.20
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $158.75
Rate for Payer: LLUH Dept of Risk Management WC $47.60
Rate for Payer: Multiplan Commercial $178.50
Rate for Payer: Networks By Design Commercial $154.70
Rate for Payer: Prime Health Services Commercial $202.30
Service Code CPT C1751
Hospital Charge Code 909000028
Hospital Revenue Code 278
Min. Negotiated Rate $294.40
Max. Negotiated Rate $1,324.80
Rate for Payer: Aetna of CA HMO/PPO $1,019.88
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1,251.20
Rate for Payer: AlphaCare Medical Group Medi-Cal $809.60
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $809.60
Rate for Payer: Anthem Blue Cross of CA Exchange $672.12
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $819.90
Rate for Payer: BCBS Transplant Transplant $883.20
Rate for Payer: Blue Shield of California Commercial $1,104.00
Rate for Payer: Blue Shield of California EPN $800.77
Rate for Payer: Cash Price $662.40
Rate for Payer: Cash Price $662.40
Rate for Payer: Central Health Plan Commercial $1,177.60
Rate for Payer: Cigna of CA HMO $1,030.40
Rate for Payer: Cigna of CA PPO $1,030.40
Rate for Payer: Dignity Health Commercial/Exchange $1,251.20
Rate for Payer: EPIC Health Plan Commercial $588.80
Rate for Payer: EPIC Health Plan Transplant $588.80
Rate for Payer: Galaxy Health WC $1,251.20
Rate for Payer: Global Benefits Group Commercial $883.20
Rate for Payer: Health Management Network EPO/PPO $1,324.80
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1,104.00
Rate for Payer: IEHP medi-cal $515.20
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $981.82
Rate for Payer: LLUH Dept of Risk Management WC $294.40
Rate for Payer: Multiplan Commercial $1,104.00
Rate for Payer: Networks By Design Commercial $736.00
Rate for Payer: Prime Health Services Commercial $1,251.20
Rate for Payer: Riverside University Health MISP $588.80
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $883.20
Rate for Payer: TriValley Medical Group Commercial/Senior $883.20
Rate for Payer: United Healthcare All Other Commercial $736.00
Rate for Payer: United Healthcare All Other HMO $736.00
Rate for Payer: United Healthcare HMO Rider $736.00
Rate for Payer: United Healthcare Select/Navigate/Core $736.00
Rate for Payer: Vantage Medical Group Medi-Cal $1,251.20
Rate for Payer: Vantage Medical Group Senior $1,251.20
Service Code CPT C1751
Hospital Charge Code 909000028
Hospital Revenue Code 278
Min. Negotiated Rate $294.40
Max. Negotiated Rate $1,324.80
Rate for Payer: Blue Shield of California EPN $786.05
Rate for Payer: Cash Price $662.40
Rate for Payer: Central Health Plan Commercial $1,177.60
Rate for Payer: Cigna of CA HMO $1,030.40
Rate for Payer: Cigna of CA PPO $1,030.40
Rate for Payer: EPIC Health Plan Commercial $588.80
Rate for Payer: EPIC Health Plan Transplant $588.80
Rate for Payer: Galaxy Health WC $1,251.20
Rate for Payer: Global Benefits Group Commercial $883.20
Rate for Payer: Health Management Network EPO/PPO $1,324.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $981.82
Rate for Payer: LLUH Dept of Risk Management WC $294.40
Rate for Payer: Multiplan Commercial $1,104.00
Rate for Payer: Prime Health Services Commercial $1,251.20
Service Code CPT C1751
Hospital Charge Code 901606421
Hospital Revenue Code 278
Min. Negotiated Rate $230.58
Max. Negotiated Rate $1,037.61
Rate for Payer: Blue Shield of California EPN $615.65
Rate for Payer: Cash Price $518.81
Rate for Payer: Central Health Plan Commercial $922.32
Rate for Payer: Cigna of CA HMO $807.03
Rate for Payer: Cigna of CA PPO $807.03
Rate for Payer: EPIC Health Plan Commercial $461.16
Rate for Payer: EPIC Health Plan Transplant $461.16
Rate for Payer: Galaxy Health WC $979.96
Rate for Payer: Global Benefits Group Commercial $691.74
Rate for Payer: Health Management Network EPO/PPO $1,037.61
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $768.98
Rate for Payer: LLUH Dept of Risk Management WC $230.58
Rate for Payer: Multiplan Commercial $864.68
Rate for Payer: Prime Health Services Commercial $979.96
Service Code CPT C1751
Hospital Charge Code 901606421
Hospital Revenue Code 278
Min. Negotiated Rate $230.58
Max. Negotiated Rate $1,037.61
Rate for Payer: Aetna of CA HMO/PPO $1,019.88
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $979.96
Rate for Payer: AlphaCare Medical Group Medi-Cal $634.10
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $634.10
Rate for Payer: Anthem Blue Cross of CA Exchange $526.41
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $642.17
Rate for Payer: BCBS Transplant Transplant $691.74
Rate for Payer: Blue Shield of California Commercial $864.68
Rate for Payer: Blue Shield of California EPN $627.18
Rate for Payer: Cash Price $518.81
Rate for Payer: Cash Price $518.81
Rate for Payer: Central Health Plan Commercial $922.32
Rate for Payer: Cigna of CA HMO $807.03
Rate for Payer: Cigna of CA PPO $807.03
Rate for Payer: Dignity Health Commercial/Exchange $979.96
Rate for Payer: EPIC Health Plan Commercial $461.16
Rate for Payer: EPIC Health Plan Transplant $461.16
Rate for Payer: Galaxy Health WC $979.96
Rate for Payer: Global Benefits Group Commercial $691.74
Rate for Payer: Health Management Network EPO/PPO $1,037.61
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $864.68
Rate for Payer: IEHP medi-cal $403.52
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $768.98
Rate for Payer: LLUH Dept of Risk Management WC $230.58
Rate for Payer: Multiplan Commercial $864.68
Rate for Payer: Networks By Design Commercial $576.45
Rate for Payer: Prime Health Services Commercial $979.96
Rate for Payer: Riverside University Health MISP $461.16
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $691.74
Rate for Payer: TriValley Medical Group Commercial/Senior $691.74
Rate for Payer: United Healthcare All Other Commercial $576.45
Rate for Payer: United Healthcare All Other HMO $576.45
Rate for Payer: United Healthcare HMO Rider $576.45
Rate for Payer: United Healthcare Select/Navigate/Core $576.45
Rate for Payer: Vantage Medical Group Medi-Cal $979.96
Rate for Payer: Vantage Medical Group Senior $979.96
Service Code CPT C1751
Hospital Charge Code 901695316
Hospital Revenue Code 278
Min. Negotiated Rate $161.00
Max. Negotiated Rate $1,019.88
Rate for Payer: Aetna of CA HMO/PPO $1,019.88
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $684.25
Rate for Payer: AlphaCare Medical Group Medi-Cal $442.75
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $442.75
Rate for Payer: Anthem Blue Cross of CA Exchange $367.56
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $448.38
Rate for Payer: BCBS Transplant Transplant $483.00
Rate for Payer: Blue Shield of California Commercial $603.75
Rate for Payer: Blue Shield of California EPN $437.92
Rate for Payer: Cash Price $362.25
Rate for Payer: Cash Price $362.25
Rate for Payer: Central Health Plan Commercial $644.00
Rate for Payer: Cigna of CA HMO $563.50
Rate for Payer: Cigna of CA PPO $563.50
Rate for Payer: Dignity Health Commercial/Exchange $684.25
Rate for Payer: EPIC Health Plan Commercial $322.00
Rate for Payer: EPIC Health Plan Transplant $322.00
Rate for Payer: Galaxy Health WC $684.25
Rate for Payer: Global Benefits Group Commercial $483.00
Rate for Payer: Health Management Network EPO/PPO $724.50
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $603.75
Rate for Payer: IEHP medi-cal $281.75
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $536.94
Rate for Payer: LLUH Dept of Risk Management WC $161.00
Rate for Payer: Multiplan Commercial $603.75
Rate for Payer: Networks By Design Commercial $402.50
Rate for Payer: Prime Health Services Commercial $684.25
Rate for Payer: Riverside University Health MISP $322.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $483.00
Rate for Payer: TriValley Medical Group Commercial/Senior $483.00
Rate for Payer: United Healthcare All Other Commercial $402.50
Rate for Payer: United Healthcare All Other HMO $402.50
Rate for Payer: United Healthcare HMO Rider $402.50
Rate for Payer: United Healthcare Select/Navigate/Core $402.50
Rate for Payer: Vantage Medical Group Medi-Cal $684.25
Rate for Payer: Vantage Medical Group Senior $684.25
Service Code CPT C1751
Hospital Charge Code 901695316
Hospital Revenue Code 278
Min. Negotiated Rate $161.00
Max. Negotiated Rate $724.50
Rate for Payer: Blue Shield of California EPN $429.87
Rate for Payer: Cash Price $362.25
Rate for Payer: Central Health Plan Commercial $644.00
Rate for Payer: Cigna of CA HMO $563.50
Rate for Payer: Cigna of CA PPO $563.50
Rate for Payer: EPIC Health Plan Commercial $322.00
Rate for Payer: EPIC Health Plan Transplant $322.00
Rate for Payer: Galaxy Health WC $684.25
Rate for Payer: Global Benefits Group Commercial $483.00
Rate for Payer: Health Management Network EPO/PPO $724.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $536.94
Rate for Payer: LLUH Dept of Risk Management WC $161.00
Rate for Payer: Multiplan Commercial $603.75
Rate for Payer: Prime Health Services Commercial $684.25
Service Code CPT C1751
Hospital Charge Code 901698429
Hospital Revenue Code 278
Min. Negotiated Rate $68.00
Max. Negotiated Rate $305.99
Rate for Payer: Blue Shield of California EPN $181.55
Rate for Payer: Cash Price $153.00
Rate for Payer: Central Health Plan Commercial $271.99
Rate for Payer: Cigna of CA HMO $237.99
Rate for Payer: Cigna of CA PPO $237.99
Rate for Payer: EPIC Health Plan Commercial $136.00
Rate for Payer: EPIC Health Plan Transplant $136.00
Rate for Payer: Galaxy Health WC $288.99
Rate for Payer: Global Benefits Group Commercial $203.99
Rate for Payer: Health Management Network EPO/PPO $305.99
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $226.77
Rate for Payer: LLUH Dept of Risk Management WC $68.00
Rate for Payer: Multiplan Commercial $254.99
Rate for Payer: Prime Health Services Commercial $288.99
Service Code CPT C1751
Hospital Charge Code 901698429
Hospital Revenue Code 278
Min. Negotiated Rate $68.00
Max. Negotiated Rate $1,019.88
Rate for Payer: Aetna of CA HMO/PPO $1,019.88
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $288.99
Rate for Payer: AlphaCare Medical Group Medi-Cal $186.99
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $186.99
Rate for Payer: Anthem Blue Cross of CA Exchange $155.24
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $189.37
Rate for Payer: BCBS Transplant Transplant $203.99
Rate for Payer: Blue Shield of California Commercial $254.99
Rate for Payer: Blue Shield of California EPN $184.95
Rate for Payer: Cash Price $153.00
Rate for Payer: Cash Price $153.00
Rate for Payer: Central Health Plan Commercial $271.99
Rate for Payer: Cigna of CA HMO $237.99
Rate for Payer: Cigna of CA PPO $237.99
Rate for Payer: Dignity Health Commercial/Exchange $288.99
Rate for Payer: EPIC Health Plan Commercial $136.00
Rate for Payer: EPIC Health Plan Transplant $136.00
Rate for Payer: Galaxy Health WC $288.99
Rate for Payer: Global Benefits Group Commercial $203.99
Rate for Payer: Health Management Network EPO/PPO $305.99
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $254.99
Rate for Payer: IEHP medi-cal $119.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $226.77
Rate for Payer: LLUH Dept of Risk Management WC $68.00
Rate for Payer: Multiplan Commercial $254.99
Rate for Payer: Networks By Design Commercial $170.00
Rate for Payer: Prime Health Services Commercial $288.99
Rate for Payer: Riverside University Health MISP $136.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $203.99
Rate for Payer: TriValley Medical Group Commercial/Senior $203.99
Rate for Payer: United Healthcare All Other Commercial $170.00
Rate for Payer: United Healthcare All Other HMO $170.00
Rate for Payer: United Healthcare HMO Rider $170.00
Rate for Payer: United Healthcare Select/Navigate/Core $170.00
Rate for Payer: Vantage Medical Group Medi-Cal $288.99
Rate for Payer: Vantage Medical Group Senior $288.99
Service Code CPT C1758
Hospital Charge Code 901607694
Hospital Revenue Code 272
Min. Negotiated Rate $4.43
Max. Negotiated Rate $19.93
Rate for Payer: Cash Price $9.96
Rate for Payer: Central Health Plan Commercial $17.71
Rate for Payer: EPIC Health Plan Commercial $8.86
Rate for Payer: Galaxy Health WC $18.82
Rate for Payer: Global Benefits Group Commercial $13.28
Rate for Payer: Health Management Network EPO/PPO $19.93
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $14.77
Rate for Payer: LLUH Dept of Risk Management WC $4.43
Rate for Payer: Multiplan Commercial $16.60
Rate for Payer: Networks By Design Commercial $14.39
Rate for Payer: Prime Health Services Commercial $18.82
Service Code CPT C1758
Hospital Charge Code 901607694
Hospital Revenue Code 272
Min. Negotiated Rate $4.43
Max. Negotiated Rate $343.17
Rate for Payer: Aetna of CA HMO/PPO $343.17
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $18.82
Rate for Payer: AlphaCare Medical Group Medi-Cal $12.18
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $12.18
Rate for Payer: Anthem Blue Cross of CA Exchange $10.72
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $13.08
Rate for Payer: BCBS Transplant Transplant $13.28
Rate for Payer: Blue Shield of California Commercial $13.93
Rate for Payer: Blue Shield of California EPN $10.83
Rate for Payer: Cash Price $9.96
Rate for Payer: Cash Price $9.96
Rate for Payer: Central Health Plan Commercial $17.71
Rate for Payer: Cigna of CA HMO $14.17
Rate for Payer: Cigna of CA PPO $16.38
Rate for Payer: Dignity Health Commercial/Exchange $18.82
Rate for Payer: EPIC Health Plan Commercial $8.86
Rate for Payer: EPIC Health Plan Transplant $8.86
Rate for Payer: Galaxy Health WC $18.82
Rate for Payer: Global Benefits Group Commercial $13.28
Rate for Payer: Health Management Network EPO/PPO $19.93
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $16.60
Rate for Payer: IEHP medi-cal $7.75
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $14.77
Rate for Payer: LLUH Dept of Risk Management WC $4.43
Rate for Payer: Multiplan Commercial $16.60
Rate for Payer: Networks By Design Commercial $14.39
Rate for Payer: Prime Health Services Commercial $18.82
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $13.28
Rate for Payer: Riverside University Health MISP $8.86
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $13.28
Rate for Payer: TriValley Medical Group Commercial/Senior $13.28
Rate for Payer: United Healthcare All Other Commercial $11.07
Rate for Payer: United Healthcare All Other HMO $11.07
Rate for Payer: United Healthcare HMO Rider $11.07
Rate for Payer: United Healthcare Select/Navigate/Core $11.07
Rate for Payer: Vantage Medical Group Medi-Cal $18.82
Rate for Payer: Vantage Medical Group Senior $18.82
Service Code CPT C1758
Hospital Charge Code 901607696
Hospital Revenue Code 272
Min. Negotiated Rate $4.74
Max. Negotiated Rate $343.17
Rate for Payer: Aetna of CA HMO/PPO $343.17
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $20.14
Rate for Payer: AlphaCare Medical Group Medi-Cal $13.04
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $13.04
Rate for Payer: Anthem Blue Cross of CA Exchange $11.48
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $14.00
Rate for Payer: BCBS Transplant Transplant $14.22
Rate for Payer: Blue Shield of California Commercial $14.91
Rate for Payer: Blue Shield of California EPN $11.59
Rate for Payer: Cash Price $10.67
Rate for Payer: Cash Price $10.67
Rate for Payer: Central Health Plan Commercial $18.96
Rate for Payer: Cigna of CA HMO $15.17
Rate for Payer: Cigna of CA PPO $17.54
Rate for Payer: Dignity Health Commercial/Exchange $20.14
Rate for Payer: EPIC Health Plan Commercial $9.48
Rate for Payer: EPIC Health Plan Transplant $9.48
Rate for Payer: Galaxy Health WC $20.14
Rate for Payer: Global Benefits Group Commercial $14.22
Rate for Payer: Health Management Network EPO/PPO $21.33
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $17.78
Rate for Payer: IEHP medi-cal $8.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $15.81
Rate for Payer: LLUH Dept of Risk Management WC $4.74
Rate for Payer: Multiplan Commercial $17.78
Rate for Payer: Networks By Design Commercial $15.40
Rate for Payer: Prime Health Services Commercial $20.14
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $14.22
Rate for Payer: Riverside University Health MISP $9.48
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $14.22
Rate for Payer: TriValley Medical Group Commercial/Senior $14.22
Rate for Payer: United Healthcare All Other Commercial $11.85
Rate for Payer: United Healthcare All Other HMO $11.85
Rate for Payer: United Healthcare HMO Rider $11.85
Rate for Payer: United Healthcare Select/Navigate/Core $11.85
Rate for Payer: Vantage Medical Group Medi-Cal $20.14
Rate for Payer: Vantage Medical Group Senior $20.14
Service Code CPT C1758
Hospital Charge Code 901607696
Hospital Revenue Code 272
Min. Negotiated Rate $4.74
Max. Negotiated Rate $21.33
Rate for Payer: Cash Price $10.67
Rate for Payer: Central Health Plan Commercial $18.96
Rate for Payer: EPIC Health Plan Commercial $9.48
Rate for Payer: Galaxy Health WC $20.14
Rate for Payer: Global Benefits Group Commercial $14.22
Rate for Payer: Health Management Network EPO/PPO $21.33
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $15.81
Rate for Payer: LLUH Dept of Risk Management WC $4.74
Rate for Payer: Multiplan Commercial $17.78
Rate for Payer: Networks By Design Commercial $15.40
Rate for Payer: Prime Health Services Commercial $20.14
Service Code CPT C2628
Hospital Charge Code 900502628
Hospital Revenue Code 272
Min. Negotiated Rate $1,087.60
Max. Negotiated Rate $4,894.20
Rate for Payer: Cash Price $2,447.10
Rate for Payer: Central Health Plan Commercial $4,350.40
Rate for Payer: EPIC Health Plan Commercial $2,175.20
Rate for Payer: Galaxy Health WC $4,622.30
Rate for Payer: Global Benefits Group Commercial $3,262.80
Rate for Payer: Health Management Network EPO/PPO $4,894.20
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $3,627.15
Rate for Payer: LLUH Dept of Risk Management WC $1,087.60
Rate for Payer: Multiplan Commercial $4,078.50
Rate for Payer: Networks By Design Commercial $3,534.70
Rate for Payer: Prime Health Services Commercial $4,622.30
Service Code CPT C2628
Hospital Charge Code 900502628
Hospital Revenue Code 272
Min. Negotiated Rate $1,087.60
Max. Negotiated Rate $4,894.20
Rate for Payer: Aetna of CA HMO/PPO $2,309.05
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $4,622.30
Rate for Payer: AlphaCare Medical Group Medi-Cal $2,990.90
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $2,990.90
Rate for Payer: Anthem Blue Cross of CA Exchange $2,633.08
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,212.77
Rate for Payer: BCBS Transplant Transplant $3,262.80
Rate for Payer: Blue Shield of California Commercial $3,420.50
Rate for Payer: Blue Shield of California EPN $2,659.18
Rate for Payer: Cash Price $2,447.10
Rate for Payer: Cash Price $2,447.10
Rate for Payer: Central Health Plan Commercial $4,350.40
Rate for Payer: Cigna of CA HMO $3,480.32
Rate for Payer: Cigna of CA PPO $4,024.12
Rate for Payer: Dignity Health Commercial/Exchange $4,622.30
Rate for Payer: EPIC Health Plan Commercial $2,175.20
Rate for Payer: EPIC Health Plan Transplant $2,175.20
Rate for Payer: Galaxy Health WC $4,622.30
Rate for Payer: Global Benefits Group Commercial $3,262.80
Rate for Payer: Health Management Network EPO/PPO $4,894.20
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $4,078.50
Rate for Payer: IEHP medi-cal $1,903.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $3,627.15
Rate for Payer: LLUH Dept of Risk Management WC $1,087.60
Rate for Payer: Multiplan Commercial $4,078.50
Rate for Payer: Networks By Design Commercial $3,534.70
Rate for Payer: Prime Health Services Commercial $4,622.30
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $3,262.80
Rate for Payer: Riverside University Health MISP $2,175.20
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $3,262.80
Rate for Payer: TriValley Medical Group Commercial/Senior $3,262.80
Rate for Payer: United Healthcare All Other Commercial $2,719.00
Rate for Payer: United Healthcare All Other HMO $2,719.00
Rate for Payer: United Healthcare HMO Rider $2,719.00
Rate for Payer: United Healthcare Select/Navigate/Core $2,719.00
Rate for Payer: Vantage Medical Group Medi-Cal $4,622.30
Rate for Payer: Vantage Medical Group Senior $4,622.30
Hospital Charge Code 901698540
Hospital Revenue Code 272
Min. Negotiated Rate $14.91
Max. Negotiated Rate $67.09
Rate for Payer: Aetna of CA HMO/PPO $45.27
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $63.36
Rate for Payer: AlphaCare Medical Group Medi-Cal $41.00
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $41.00
Rate for Payer: Anthem Blue Cross of CA Exchange $36.09
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $44.04
Rate for Payer: BCBS Transplant Transplant $44.72
Rate for Payer: Blue Shield of California Commercial $46.89
Rate for Payer: Blue Shield of California EPN $36.45
Rate for Payer: Cash Price $33.54
Rate for Payer: Central Health Plan Commercial $59.63
Rate for Payer: Cigna of CA HMO $47.71
Rate for Payer: Cigna of CA PPO $55.16
Rate for Payer: Dignity Health Commercial/Exchange $63.36
Rate for Payer: EPIC Health Plan Commercial $29.82
Rate for Payer: EPIC Health Plan Transplant $29.82
Rate for Payer: Galaxy Health WC $63.36
Rate for Payer: Global Benefits Group Commercial $44.72
Rate for Payer: Health Management Network EPO/PPO $67.09
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $55.90
Rate for Payer: IEHP medi-cal $26.09
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $49.72
Rate for Payer: LLUH Dept of Risk Management WC $14.91
Rate for Payer: Multiplan Commercial $55.90
Rate for Payer: Networks By Design Commercial $48.45
Rate for Payer: Prime Health Services Commercial $63.36
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $44.72
Rate for Payer: Riverside University Health MISP $29.82
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $44.72
Rate for Payer: TriValley Medical Group Commercial/Senior $44.72
Rate for Payer: United Healthcare All Other Commercial $37.27
Rate for Payer: United Healthcare All Other HMO $37.27
Rate for Payer: United Healthcare HMO Rider $37.27
Rate for Payer: United Healthcare Select/Navigate/Core $37.27
Rate for Payer: Vantage Medical Group Medi-Cal $63.36
Rate for Payer: Vantage Medical Group Senior $63.36